Evaluation of the Alvarado score in acute abdominal pain

Background: Alvarado score is usually evaluated for patients who suffer from appendicitis. The goal of this study was to compare the Alvarado scores in patients who suffered from abdominal pain regardless of their causes.
Materials and methods: In a prospective study, 300 patients with acute abdominal pain who were referred to an Emergency Room were evaluated for Alvarado score regardless of the cause of the pain.

Results: From 300 patients, 257 patients (85.66%) had Alvarado scores 7 or less and 43 patients (14.33%) had Alvarado scores higher than 7. In this study, 66 patients from (25.7 %) with Alvarado scores 7 or less had Appendicitis, compared with 40 patients (93%) with Alvarado scores higher than 7, which showed statistically significant differences.This finding suggests that patients with abdominal pain and Alvarado score>7 are very likely suffered from Appendicitis. This scoring system seems to have 95% specificity for Appendicitis but a poor sensitivity (37%).
Conclusion: Alvarado scoring system in patients with acute abdominal pain could be used to predict Appendicitis. A positive test (Alvarado >7) would result in a 93% chance of appendicitis, whereas a negative test (Alvarado ≤ 7) would result in a 26% chance of appendicitis. So, this is a good rule-in test, but not an adequate rule-out test.